Residents of low-dependency ‘care homes’ in the southeast face an uncertain future

The future accommodation of almost 300 older people in the southeast is in doubt unless a new funding stream can be found for their accommodation.

Jim Daly, Minister of State with special responsibility for Older People, has described the type of housing in which they live – provided at 10 locations in counties Kilkenny, Waterford and Kilkenny – as “very much the future” and yet, he says, they do not “fit” into any existing funding stream.

A total of 279 older people live in the low-dependency “care homes”. They are neither sheltered housing nor nursing homes, but somewhere in between.

Residents in the homes in such village and rural communities as Graiguenamanagh in Co Kilkenny and Lismore in Co Waterford, have their meals provided, laundry done and any medical issues attended to, but come and go as they please.

They were founded in the 1970s by Bishop Peter Birch, Sr Patricia Dee and Sr Stanislaus Kennedy, and were run on an almost exclusively voluntary basis by the Franciscan Missionaries of St Joseph until May 2016.

Since the religious order pulled back, the homes have established voluntary boards of management, must meet all Hiqa criteria and, though they do not employ medical staff in the way nursing homes do, they now employ managers, cooks and cleaners – all of whom are paid little more than, or just, minimum wage.

Subvention

They get a subvention of about €5,500 per resident per year from the HSE, compared with about €45,000 per resident in a nursing home.

The homes charge residents between €200 and €300 per week, based on income, supplementing this with ad hoc lottery grants and fundraising.

These care homes are unique, an outlier even. I see them very much the future for long-term housing for older people

The late Fr Nicholas Flavin – who represented the homes until his death over the summer – in a letter to the HSE dated 4th July, said: “The financial state of the homes is extremely critical . . . Without a sound financial basis, the supported care homes are in danger of being reckless traders, and thus there is a very strong possibility that all members of the management of the homes would resign as the impact of reckless trading . . . The implication of this would be the immediate closure of the homes.”

Mr Daly, who visited the homes earlier this month, told The Irish Times he would like to see the low-threshold model replicated across the country.

“These care homes are unique, an outlier even. I see them very much the future for long-term housing for older people. The problem is they don’t fit into any existing funding stream. Although they get a small subvention from the HSE, they do not get any funding from other departments, like the Department of Housing, because they are not, strictly speaking, regarded as ‘housing’.”

He wants to see new funding streams, including through local authorities, to fund schemes like those in the southeast. He will host a conference in Dublin in November to look at this.

Married life

Originally from Co Meath, she lived most of her married life in Dundalk, Co Louth where her husband was a garda. On his retirement 13 years ago, they moved to his native north Kilkenny, settling in Lisdowney – six kilometres from Freshford.

The company has been marvellous. I’d say they have restored me

“He died very suddenly in September 2016. I wasn’t in good health at the start of 2017 and had to go into hospital. The hospital wanted me to go into a nursing home and I was miserable about that. I didn’t need a nursing home.

“I knew about this place and I rang someone and I was lucky. There was a space and I came here in May last year. It’s like a home from home,” she says, sitting in the bright diningroom overlooking the village.

“The company has been marvellous. I’d say they have restored me. We have our breakfast in our rooms about 7am and there’s always a cup of tea in here at 10am. Some days I go into Kilkenny. We’re well looked after here and I’m very happy.

“It would be terrible if it was to close. I wouldn’t like that at all.”

Mr Daly has secured one-off HSE funding for the 10 homes to the end of the year. Paul Murphy, chair of the board at Prague House, says, however, their future is “far from secure”.

A spokesman said: “The HSE South East Community Healthcare is working closely with various supported care homes across the southeast, as regards continued delivery of services in 2018 and for 2019.”